Thursday, July 30, 2009

Best Damn Editorial in a long time.

Those of you that faithfully follow this blog know a few things, number one, I am not a fan of the DNP degree mandate for several workforce supply issues and reasons that I have expanded on in the past. Secondly, I have been saying for months, that trying to simply expand coverage, and NOT implement or attempt to reign in the substantial increases in healthcare spending that occur annually, will NOT WORK. It's that simple.

YOU CANNOT ESCAPE THE RULE OF 6.9%. In a year, FY2008, which saw the worst economic collapse in five decades, and saw the year finish with NEGATIVE GDP growth. Yep,
-5.8%, healthcare spending still increased by 6.9%. Businesses which saw record losses, and had to cut staff, production, and benefits, saw health premiums increase by 5% on average. The current iterations put forth by the house, and the HELP version from the Senate DO NOT DO THIS. SO, we will simply be spending ourselves further and further into oblivion.

Right now, by 2050, Medicare and Medicaid spending alone will consume almost all federal taxes levied, and by 2080, Medicare will consume MORE than all federal taxes collected. This year, 2009, the predicted increase in healthcare spending will be close to 7.4%, and for every year now for decades, healthcare spending increases have outpaced GDP growth. It cannot continue.

This idea, of taxing healthcare, may help. It is one of the few ideas coming out of congress that actually has merit, but it is politically unpopular, cause most americans don't really understand macroeconomics, or the real, REAL need for restraint in healthcare spending.

If the economy could stay elastic and continually expand, we wouldn't even have any of this conversation, but it cannot. In fact, right now, it is still contracting, although the latest economic indicators show that this had slowed substantially, healthcare does not respond like a typical commodities market. Cause it's not. Right now, as most of you know, we have a mixed payor system. Unfortunately, this is the worst of both worlds. Anyway, please read:


Trip Home with my Daughter

SO, I decide to take my 3 year old daughter home last week for a family reunion. Let me tell you folks, a 12 hour car ride BY YOURSELF with a 3 year old is not something to be taken lightly. She did so, SO good though. She truly was Daddy's big little girl. She loved being at the farm and seeing my mom, and at the tender age of 3, rode a horse for the first time BY HERSELF. Last year, she'd sit on the saddle, but only if mom or dad were with her. For those that are wondering, my wife's brother is terminal with stage IV adenoca of the lung, and her father is also quite ill as well. She does not have much leave from work currently, and decided to stay home to save leave.

I will say that having a 3 year old cry, and scream that they have to "GO POTTY" while you are stuck in construction with no exits anywhere in sight is a new experience for me.

Friday, July 17, 2009

Prometheus is upon us.....

WHOA, the physician community is not so happy about this.

This is a new system funded by the Robert Wood Johnson foundation, and is akin to forced capitation. Obama and the current administration are quite interested in this, and various states, including my own are thinking about implementing it as well. I'd be interested in Happy's take on this.

I wonder how the guys in McAllen would take this.....(ducks)


20th High School Reunion

Wow, what the hell happened? HOW has it been 20 years already. I didn't go to my 5th or 10th, or any of my other reunions, but I just finalized my travel plans to go back in about 3 weeks for my 20th. Like anything, there will be some people I really want to see and catch up with, and others that I didn't know really well. Oh well, a good bottle of 21 year old MacCallan, and life is good.

Pneumonia SUCKS

Wow, I can't remember being this sick in a long time. I was diagnosed almost two weeks ago. Left lower lobar consolidation. Treated appropriately, but I am still coughing stuff up. Missed a couple of days at work initially, cause I just couldn't go. I can tell I am getting older. When I was 15 years younger, I would have recovered in a few days, but I am still getting over this 2 weeks later.....WTF?

Sunday, July 5, 2009

Pay Cuts for Specialists, and increases for Primary Care..

Obama's initiative to CMS, re-allocate your re-imbursements! Estimates are that primary care physicians could see a pay increase of 6-8%, while some specialists, specifically cardiology as mentioned, could see BIG decreases. 11% overall, but up to 42% for procedures like echocardiograms.

Big changes...


Thursday, July 2, 2009

AMA does 180

SO, I think the AMA is doing their very best imitation of John Kerry at the moment, first they were against it, and now.......not so much.


Just gotta wonder.

Walmart...makes me laugh

SO, Walmart, the nations LARGEST private employer with 1.4 million employees is supportive of an employer mandate from congress for all employers to provide insurance. If only they were so accomodating to all of their employees. While I am not opposed to a mandate, I find it somewhat comical that a company with 36,000 employees on MEDICAID, yes, Medicaid, and has historically been somewhat reluctant to expand employee benefits would suddenly "see the light". I think that this is likely more of a power play by Walmart, to force some of their smaller competitors to provide benefits that they themselves are not even currently providing. I find it somewhat interesting considering that according to this article, only 53% of Walmart employees have health insurance sponsored by Wally, and 6% of their employee population is completely UNINSURED. Interesting statements made by them.

See more HERE